Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 5201007938 | MI |
NPI | 1043712144 |
---|---|
Provider Name | Heather Ann Bowen |
First Address | Ann Arbor, MI 48109-0100 |
Second Address | Ann Arbor, MI 48109-0100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2018 |
Last Update Date | 05/03/2018 |